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Building a Gratitude Culture

Gratitude has become quite the buzzword in recent years, but it is more than just a trend. Science proves gratitude, practiced frequently and correctly, can change people’s attitudes, positively impact cultures and play a significant part in the healing process. This realization has resulted in successful organizations actively building gratitude into their cultures. How is this accomplished while staying focused on patient care?

To understand why gratitude is important, let’s first define it. Accordant Philanthropy® Senior Science Advisor Robert A. Emmons, PhD, describes gratitude in his book, Gratitude Works!, as “an affirmation of goodness and recognition of goodness outside ourselves.” Lexico defines gratitude as “the quality of being thankful; readiness to show appreciation for and to return kindness.” Gratitude is often taught at an early age, and its importance is noted through a specific US holiday. It is no wonder we yearn for the human connection gratitude brings in our workplace.

Scientific evidence shows many benefits of gratitude at work:

  • Increased productivity

  • Improved well-being

  • Bolstered mental strength

  • Elevated job satisfaction

It’s understandable gratitude contributes to holistic and effective treatment plans for patients. It is also important to recognize gratitude positively impacts clinicians themselves, thereby improving care delivery. The Greater Good Science Center at the University of California, Berkeley, found saying “thanks” at work makes people feel happier—and hearing “thanks” makes them happier and more productive by 50%! Hearing “thank you” also builds self-worth and self-efficacy as well as trust between coworkers. That’s powerful.

Building a culture of gratitude is critical to achieve our goals in health care philanthropy. Without gratitude, our philanthropic partners would not be interested in giving back to the organizations that healed them. To create an environment that fosters gratitude in patients, we now know it is important to create an environment for caregivers that allows them to give and receive gratitude. How can this be accomplished?

Without gratitude, our philanthropic partners would not be interested in giving back to the organizations that healed them.

Ed Tori, DO, Director of the Influence Center at MedStar Health in Columbia, MD, offers some insight. “Where attention goes, energy flows,” Ed says referencing his guiding principle. “Draw attention to gratitude, and we will see more of it,” he adds. “In this age of ‘hyper-metrics’ it is important that health systems keep data in its proper place. Data tells us where to go and, sometimes, how to get there. Data is not very good, however, at moving us there. Emotion does that. There is nothing irrational about using emotional appeal. It is a must. It’s what moves us.”

Ed’s team conducted a research project in nursing units focusing on patients and staff experiencing and expressing gratitude. They implemented Mindfulness Mondays, providing three opportunities a day for staff to learn how to manage their state. Social profile assessments matched staff interests with patients who self-identified similar interests to ensure ideal chemistry between patient and caregiver. Thank you cards were provided to patients to express gratitude. After four short months, three units had a total of 596 thank you cards given by patients, resulting in one of these units having significant increase in staff satisfaction scores and two units with significant increases in patient experience scores.

Health care systems and organizations that successfully build a culture of gratitude demonstrate key characteristics noted by the Greater Good Science Center in partnership with Dignity Health, Kaiser Permanente, Sharp Best Health, Scripps Health and Sutter Health. The gratitude culture is always supported by and started with the executives and filtered to the entire staff. Gratitude must be seen as more than just a soft skill that is nice to have, but rather as a necessary skill for all staff to practice.

Individual practice contributes to systemic change that is hardwired into the culture. Simple initiatives, such as thank you notes, allow staff and patients to express their gratitude. Identifying important life milestones through notes and celebrations brings recognition to staff members. Gratitude must be voluntary and authentic. Something said in a disingenuous spirit or that feels forced won’t elevate the culture. Make it real. And make it year-round. To be authentic, gratitude must be practiced consistently.

Those in health philanthropy must actively support the executives and remain diligent in demonstrating how a culture of gratitude produces grateful patients, ultimately contributing to our missions. When gratitude is measured in terms of revenue, it becomes a game-changer in patient experience, employee satisfaction and the bottom line.

Accordant White Paper_Gratitude Culture
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About the Author: Pam Maroulis, CFRE, is a Principal Consultant with Accordant Philanthropy. You can reach her at


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The Accordant Team has published a number of books to advance the efforts of health care philanthropy and help development leaders everywhere. 

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Accordant is honored to collaborate with American Hospital Association Trustee Services to provide issue papers, templates and webinars to support the involvement of healthcare trustees and foundation board members in advancing philanthropy. These resources can also be found on the AHA Trustee website.

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